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目的 :应用血浆置换预防和治疗肾移植排斥反应 ,以提高肾移植手术的成功率。方法 :采用双滤过法血浆分离术和膜分离法治疗 2 4例术前高度致敏者 (其中 2例准备行第二次肾移植手术 )和 7例肾移植术后排斥反应。结果 :2 4例术前高度致敏者 ,经 3～ 5次血浆置换去致敏抗体后 ,2 2例接受肾移植成功 ,其中2例术后发生超急排斥 (HAR) ,但术后又经 2次血浆置换治疗后 ,1例肾功能延迟恢复 ,1例移植肾失功 ,摘除移植肾。 7例肾移植后抗排斥治疗 ,配合抗排斥药物 ,1例HAR患者治疗失败 ,1例急性排斥 (AR)者经继续行血浆置换治疗 2～ 3次后 ,肾功能恢复。结论 :血浆置换疗法是预防和治疗肾移植术后排斥反应的有效方法。
Objective: To prevent and treat renal allograft rejection by plasma exchange in order to improve the success rate of renal transplantation. Methods: 24 cases of preoperative hypersensitivity (2 cases were prepared for second renal transplantation) and 7 cases of renal allograft rejection were treated by double filtration and plasma membrane separation. RESULTS: Twenty-four cases of preoperative hypersensitivity were successfully treated with sensitized antibodies after 3 to 5 times of plasma exchange. Among them, 2 cases had hyperacute rejection (HAR) after operation, but after operation After 2 times of plasma exchange treatment, 1 case of delayed renal function recovery, 1 case of graft failure, removal of kidney transplant. Seven patients were treated with anti-rejection after renal transplantation, with anti-rejection drugs. One patient with HAR failed the treatment, and one patient with acute rejection (AR) was treated with plasma exchange twice or three times before renal function recovered. Conclusion: Plasma exchange is an effective method to prevent and treat rejection after renal transplantation.